THE SINGLE BIGGEST KILLER OF YOUNG WOMEN
is now the single biggest infectious killer of women in the world,
according to an international research meeting on TB and gender held in
Data presented by the World Health Organisation (WHO) at the
meeting showed unprecedented levels of infection and deaths among women
and girls: over 900 million are infected with TB world-wide, one million
will die and 2.5 million will become sick this year from the disease -
mainly between the ages of 15 and 44.
makes TB the single leading cause of deaths among women of reproductive
''Wives, mothers and wage
earners are being cut down in their prime and the world isn't noticing,''
said Dr Paul Dolin of WHO's Global Tuberculosis Programme.
the ripple effect on families, communities and economies will be felt long
after a woman has died.''
No other infectious illness creates so many orphans.
This counters perceptions in wealthy countries where the disease is most commonly found in
In industrialised countries, one quarter of all TB cases occur in
the over-65s, compared with only ten percent in developing countries or Africa, Asia and Latin America.
In the developing world, TB is predominantly a disease of young adults: 60
per cent of all cases are young men and women of reproductive age.
accounts for 9 per cent of deaths world-wide among women aged between 15
and 44, compared with war which accounts for 4 per cent, HIV 3 per cent
and heart disease 3 percent.
Women of reproductive age are more susceptible to fall sick once
infected with TB than men of the same age.
Women in this age group are also at greater risk from HIV
As a result, in parts of Africa, young women with TB outnumber
young men with TB.
''Among leading threats to
women's health, TB may be the most affordably controlled,
Professor Vinod Diwan of the Nordic School of Public Health, where the
meeting was held.
losses to this disease have prompted a search of factors such as gender
that may help us to better understand and better control the epidemic.''
first major international meeting to be held on TB and gender was held on
(24 - 26 May 1998) was organised by the Nordic School of Public Health
Umea University and Karolinska Institute in Sweden, and co-sponsored by
the Swedish International Development Co-operation Agency (SIDA) and WHO.
SIDA's Department for Research Co-operation (SAREC) supports TB and
and gender experts met to draw up an agenda for research into biological
epidemiological, social and cultural differences in the occurrence of TB
in men and women, and their access to the TB treatment strategy DOTS,
recommended by WHO.
Specific areas of research will be TB in women, adherence to
treatment, and patient education.
''Improved access to DOTS could
prevent many needless deaths among and children and improve our control of
this infectious killer,'' said
Dr Dolin of WHO.
services, flexible opening hours for clinics, and health workers trained
to respond to women's needs could make DOTS more user-friendly for this
''We need to ensure that
our health systems are delivering DOTS in ways that remove rather than
Professor Diwan of the Nordic School of Public Health.
interventions must protect this already vulnerable group.''
Observed Therapy, DOTS, combines five elements: political commitment, case
detection through sputum smear microscopy, directly observed short-course
treatment, regular drug supplies and monitoring systems with evaluation of
treatment outcome for each and every patient.
Once infectious cases have been detected using microscopy services,
health and community workers and trained volunteers observe and record
patients swallowing the correct dosage of anti-TB medicines, and documents
that the patient has been cured.
study by the World Bank, WHO and Harvard University shows TB as a leading
cause of 'healthy years lost' among women of reproductive age.
8.7 million 'disability adjusted life years' (DALYs) were lost as a
result of TB compared with 8.5 million due to sexually transmitted
diseases and 2 million due to malaria.
GENEVA 27 SWITZERLAND.
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